Provider Demographics
NPI:1578069076
Name:VILLADA, ALANA MICHELE (DO)
Entity Type:Individual
Prefix:MS
First Name:ALANA
Middle Name:MICHELE
Last Name:VILLADA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4700 NELSON BROGDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5400
Mailing Address - Country:US
Mailing Address - Phone:678-431-6380
Mailing Address - Fax:678-288-1064
Practice Address - Street 1:4700 NELSON BROGDON BLVD
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5400
Practice Address - Country:US
Practice Address - Phone:678-341-6380
Practice Address - Fax:678-288-1064
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC1578069076207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program